ABSTRACT

A company’s role in creating antecedents to error has been increasingly recognized. The New York Times account of the 1999 accident at a Japanese uranium processing plant suggests that the operator errors that led to the accident were a direct result of management actions and decisions. A subsequent New York Times article revealed that plant managers compounded the effects of their initial actions by not developing an emergency plan in the event of an incident (French, 1999). Apparently, the managers believed that an accident could not occur and therefore, none was needed. This chapter will address how companies can create antecedents to error in the systems that they oversee and operate.